Fill the immunization medical exemption's child and parent fields, fast

A medical exemption from school immunization requirements uses a Statement of Medical Exemption that a physician or nurse practitioner completes — on top of the child and parent details. This guide is an example of letting hivi handle the repeating fields.

Official form and source

Start from the official source and always use the current version — form numbers and links can change:

• Service page: Vaccines for children in schools — ontario.ca
• Form (Central Forms Repository): Statement of Medical Exemption — 014-4895-64

What this form is about

The statement records a medical exemption from vaccine requirements under the Immunization of School Pupils Act, certified by a physician or nurse practitioner.

Before you start: what to gather

• The child's name and details.
• The parent or guardian's details.
• Your physician or nurse practitioner to complete the medical section.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Store your family details once. Save the child and parent details in hivi.
2. Autofill the repeating fields. Use the hivi Chrome extension on a web form, or fill a PDF from your saved details inside hivi.
3. Your practitioner completes the medical part.
4. Submit yourself to your local public health unit.

Why do it in hivi

The child and parent details here also appear on school and health forms. Stored once in hivi — in Canada, with no third-party AI — the repeating fields fill themselves.